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Home My WebLink About04-09-09 (2)r~ 'r 1505607120 REV-1500 ~( (06-05) OFFICIAL USE ONLY PA Department of Revenue courrty coda Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX.280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 0 8 12 41 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 174 18 8736 12-03 2008 02 22 1919 Decedent's Last Name Suffix Decedent's First Name MI LULEY ESTHER R (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW X^ 1. Original Retum ^ 2. Supplemental Retum ^ 3, Remainder Retum (date of death prior to 12-13-82) ^ 4. Limited Estate ^ qa. Future Interest Compromise d ~ 5. Federal Estate Tax Retum Required ( ate of death after 12-12-82) g, Decedent Died Testate (Attach Copy of Wilq ^ ~, Decedent Mavrtained a Living Trust (Attach Copy of Trust) Q 8. Total Number of Safe De posit Boxes 9. Litigation Proceeds Received ^ 1 D, Spousal Poverty Credit (date of death 11, Election to tax under Sec. 9113 A between 12-31-zJ~ and ~-~-ss) ^ ( ) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JAMES D. BOGAR 717 737 8761 Firm Name (If Applicable) BOGAR & HIPP LAW OFFICES First line of address ONE WEST MAIN STREET - Second line of address City or Post Office SHIREMANSTOWN State ZIP Code PA 17011 Correspondent'se-mailaddress: Jbogar@bogarlaw.com REGISTER O~ LLS USE ~LY ~o - ~ .: ~., _~ .~ ~ C7 ~7 ~~~rn ~ I - ~ '-v; - ~ . J ~-t DATD -~,, :~~ f ..~ t`! {_ ~~ ~~ r-! + t '"~') ~, Under penalties of perjury, I dedare that I have examined this return, induding accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.~clarat~f pre~rarer other than the personal representative Is based on all information of which preparer has any knowledge SIt;NA IRF F PF Au RGeP uci c ^-"~'~r j - -j `_....__. j..,,.~~ .~,,.. ~~.~.~~.~ ~ .,n~U DATE x L~~ Richard F. Luley 5 Emlyn Lane, Mechanicsburg, PA 1 iIGNA F PREP9REftnTHER THAN REPRESENTATNE James D. Bogar N One West Main Sfl~eet, Shiremanstown, PA 17011 Side 1 1505607120 1505607120 J 15056D7220 REV-1500 EX Decedent's Social Security Number om~SNeme: Esther R. Luley 174 18 8736 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5• Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ................ 5. 2 5 0 , 7 6 5 . 5 0 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 2 , 14 7 . 6 8 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7. 2 , 1 6 8 . 7 8 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8, 2 5 5 , 0 81.9 6 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 1 7 , 5 6 4 . 8 8 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 ~ 10) ...................................................................... 11. 17 , 5 6 4 . 8 8 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 2 3 7 , 51 7 . 0 8 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................................................. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ................................................. 14. 2 3 7 , 5 1 7 . 0 8 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .o0 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable _. _ __ at lineal rate X .045 2 3 7, 517.0 8 16• 10 , 6 8 8. 2 7 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17• 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18• 0. 0 0 1 s. Tax Due ..................................................................................................................... 19. 10 , 6 8 8. 2 7 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505607220 15056D7220 J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENTS NAME Esther R. Luley STREET ADDRESS 5225. Wilson Lane Mechanicsburg CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applipble p, Interest E. Penalty Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Llne 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difffference. This is the TAX DUE. q. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (1) 10,688.27 (2) 10,620.00 (3) (4) (5) 68.27 (5A) (5B) 68.27 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No _ __ a. retain the use or income of the property transferred :.................................................................................. x b. retain the right to designate who shall use the property transferred or its income :..................................... x c. retain a reversionary interest: or .................................................................................................................. x d. receive the promise for life of ekher payments, benefits or care? .............................................................. x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... ^ x^ 3. Did decedent own an "in trust fora or payable upon death bank account or security at his or her death?......... ^ ^x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................... ~ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. •§9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemat a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)j. The tax rate imposed or the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. File Number 21-OS-1241 10,089.00 531.00 Total Credits (A + B + C) cou~aoNwEA~TH of t>ENNSr~vANw MMERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Luley, Esther R. 21-08-1241 Inchde the proceeds of ~tipation and the date the proceeds were received by the estate. All property jointly-owned whh the rlpM of survivorship must be dlsdossd on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Wachovia Securities Investment Account -Date of death valuation 244.281.49 2 Wedding Rings -per appraisal 1.315.00 3 Asbury Communities, Inc. -Refund 241.00 4 Commonwealth of Pennsylvania - 2007 Personal Income Tax refund 213.00 5 Commonwealth of Pennsylvania - 2008 Personal Income Tax Refund 92.00 6 Encompass insurance Company -Refund of renter's insurance premium 43.01 7 Thrivent Financial for Lutherans -Refund of long term care insurance premium 1,881.00 8 U.S. Treasury -Refund of 2008 Personal Income Taxes 1.590.00 9 U.S. Treasury - 2007 Personal Income Tax Refund 1.109.00 TOTAL (Also enter on Line 5, Recapitulation) I 250,765.50 (It more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Wachovia Securities, LLC 2077 East Warner Road Suite 101 Tempe, AZ 85284 Tel 480 732-0154 Fax 480 8140187 800 762-0154 December 12, 2008 James D. Bogar Attorney at Law One West Main Street Shiremanstown, PA 17011 Dear Mr. Bogar: ~Ta~~®~ 5'~cu~a~s The following represents the date-of--death valuation as of December 3, 2008 for the assets in the account of Esther R. Luley at Wachovia Securities: $4,783.09 AGE Bank Deposit Program $14,410.00 1,100 Countrywide Capital N 6.75% Trust Pfd. Secs. @ $13.10 $22,012.20 23,000 Food Lion Inc. 8.05% due 4-15-27 @ 95.7052 $328.50 300 GMAC LLC 7.375% note due 12-16-44 @ $4.095 $9,957.50 500 JP Morgan Chase Cap. XI 5.875% Cum. Tr. Pfd. Secs. @ $19.915 $2,700.00 200 Morgan Stanley Cap. Tr. N 6.25% Tr. Pfd. Secs. @ $13.50 $16,400.00 40,000 SLM Corp. x.00% due 6-15-19 @ 41.00 $5,893.20 12,000 Sprint Capital Corp. 6.875% due 11-15-28 @ 49.11 $16,675.00 1,000 US Cellular 8.75% Senior Notes due 11-1-32 @ $16.675 $7,002.00 300 Wells Fargo Cap. Tr. 7.00% Tr. Pfd. @ $23.34 $20,214.60 21,000 Federal National Mortgage Asn. 6.125% Note due 2-6-26 @ 96.26 $9,451.34 4,740.295 Morgan Stanley High Yield Secs. Cl. A @ $1.15 $19,110.00 1,400 Corporate Office Pptys. Tr. 7.625% Pfd. Series J Cum. @ $13.65 $6,753.75 750 HRPT Pptys. Tr. 7.125% Pfd. Cum. Redeemable Ser. C @ $9.005 $10,598.00 757 Highwoods Ppty. Inc. 8.00% Pfd. Cum. Redeemable @ $14.00 $2,808.00 300 AEGON NV 7.25% Pfd. Capital Secs. @ $9.36 $14,571.90 661.457 DWS Value Series Inc. Dreman Small Cap Value @ $22.03 $15,745.76 720.300 Davis New York Venture Fund Inc. Cl. B @ $21.86 $1 e, i 78.72 88.487 Growth rhna of America C1. 13 @ $ i b.9 7 $12,885.17 891.0909 Morgan Stanley Mid Cap Growth Fund @ $14.46 $15,202.76 1,202.75 Templeton Growth Fund Inc. Cl. A @ $12.64 $244,281.49 TOTAL VALUATION AS OF DECEMBER 3, 2008 Please call me at (800) 762-0154 ext. 304 if I may be of further assistance. Sincerely, ~~~ Thomas A. Luley Associate Vice President-Investments Financial Advisor ~'S, /i~` . , .~ ~()SEp~I 1AME5 JEWELERS 'I'CS W!iOM I'I' MAY t:UN('IiRN: 'flliA it to urtiry Ih11 xa; An eiyAQyQ In Ihu1^wh' hWatuA4 oppnlAinY dIAIIWndA. wAtohrA, JcwWry end prcaieuA cones ~>t'Ail dewriplinne. wa ~+rvwilll aeniry Ihvr .n: hew lhis dAy un:N11Y aamineil llq fuuwving figod M+Q damihel AmeloA, urn V+nR+IY nr NAMH: f9xtptc of I:J;ther l.ulcy Ai)DRJ:S,S: c% Richard l.ulay 5 Hmlyn I.anc Mcchnnir,~ury,. NA 1T055 Wt eeliaule the vAlne V uAlAd r•. inAUrAnoA,K uthor purp,AeA Af tho NMant roldl value, aAAlxdiny Noderd eml other toes In malfinY Ihb AnnrAiAA1 wu Y10 NrPr nyrAr to qurahus ur raplAw We uNclnc i _ _ The foliawinR items were evaluated for e:ta#e purposes. . Lxdy'~ 114K white gold diamond engagement ring. The round brilliant cut diamond measures ap~roaimately ti.21 mm x 6.24mm and 3.9mm deep. 'This diamond weighs approximately .92ck The clarity is VS`. The color is (i. The table is approximately 61 "/o.:1'hc depth is approximately 62.7"!0. This is framed with lour; 2.Zmm round brilliant cut diamonds, .16ctw. The clarity of these diamlmds is VS. 'Phe eotor is G-[~. Bach ix bead/pave' set. 's'he crt,wn is 14K whito gold with six prongs. 1~he hinging adju.A:tahle shank measures S.Omm tapering to 2.8mm. 't'his is cunxtructed from a multi piece cast assembly. Yafpe: S1,2itf,QO .: ~ .. ;; mod; rw,-=~~t~ti~u'.. December 3, 2008 . AMI=.. . nAVIS P.C. 'fM rnralµ,hM Alryreiwl ie made wish the unolaneending Iluu Iha ApprSier AuwmAe m IIAllllfy WIIh loApeef fn Ilm' ANbn fhAl n111Y hA fAkAn on IhA hAele P(IhU spMtlIAAI 301 Eat: Main Street • Mschanicaburg, IcA 1755 • (717) 796-3224 .~ f~ ~OSEpIi aIAMES .~EWELEItS TP W! it)M 1'!' MAY ('ONCliRN: '17un it to crnilY that wa aro cn~ad in dlnlnwdry hnaiaaaa. appraiainy dlamondn, wnteha~ jawatry ami prnirma nrr~Ya ornl7 dexerlininni Wr ltrrowirn ~brtify that we hRVc th~r dq amhdly r.atninM utc tullnwing b•trd artd dnen r~rd attleiea, rhr pmpany nl: NAMI?: Hxtslu of l:,ther l.uley Al)!)Itiilti: c/tt Ri4~itt-rd t.uldy 5 flmlyn I.Mc Mt:oh+inic,~burq, NA 17DSS Wv ralirMrr Ilte vnltu~ as lialyd by inaWRnrt nr shat pla'jMldn tl Iltr tLrrem reutil wlua. aatefuding I+rdw,tl and ntiw unan, In making lhia Approlanl we D<! NUT aytt+r m p+uclrise M rcplrW the u dclas -, .__ ..~_ ._ ,.__ .. ~ -- r The tolbwin~ items were evacuated tar estate purpotsc~r AFSC:gl~rl~ Lady's 14K white gold wedding ring. Thc flat wedding bAnd measure approximately 4mrn in width. The hinging adjustable shank measure, S,Omm tapering to 2.Smm. 'I'bis is c~natructed from a multi )iecc cast a.;scmbly. Valae; T65.00 ?1~~;;'•'l'i~ =,~r7'?a,7u,tdl.~.~F~c ti =i a r tt Al' IA (^~, ,t:~:v. .~,. f.1M; 1~..xMf~.i M.:' ~J n ~^~ I)ecembcr 3.200, '11u Nrryniag Appraisal is madr with tha undtuatandlnk that lha Appraiaar nrWmar a~ llaNilhy with reapant to any nnlion Thai mar br Inken nn Ihv h~aia nl rltla hlTraiSal ~n1 f.~~t Main Street • M.:cheniastsurg, PA 17055 • (717) 795-92?4 ' " Rev-tsos t:x+ Ir-sB- SCHEDULE F conanoNwEA~nioFPeNNSYLVANw JOINTLY-OWNED PROPERTY INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Luley, Esther R. 21-08-1241 Han asset was made joint within one year of the decedent's date of death, It mist be roported on sdrodula Q SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Richard F Luley 5 Emlyn Lane Son Mechanicsburg, PA 17055 B, Nancy Luley 5 Emlyn Lane Daughter-in-Law Mechanicsburg, PA 17055 C. JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT DATE MADE DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMB DATE OF DEATH % OF DECD'S DATE OF DEATH VALUE OF TENANT JOINT ER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASS INTEREST DECEDENTS INTEREST 1 A & B 8/24/2006 PNC Bank Checking Account -date of 6,443.04 33.333% 2.147.68 death balance $6,432.83; accrued interes $0.21. This account was jointly owned with Richard F. Luley and Nancy Luley. TOTAL (Also enter on Line 6, Recapitulation) I 2,147.68 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) ~ ! ~~ c~~xH~wax December 24, 2008 James D Boger Attorney at Law • One West Main St Shiremanstown, PA 17011 RE: Esther R Luley SSN: 174-18-8736 DOD: 12-03-2008 Dear Mr. Boger: In response tp your request for Date of Death (DOD) balances for the customer noted above, our records show the following: Checlting Account Account # 4132828 Established: 08-24-2006 ESTHER R LULEY RICHARD F LULEY NANCY LULEY DOD balance: $ 6,432.83 + 0.21 accrued interest Please note that. this office provides date of death balances for deposit accounts (IItAs, CDs, Checking and $avuags). We do cot process say ~asncial transactions or provide statements. ffyou need assistance with any of these items, please call 1-888-PNC-BANK (1-888-?62-2265) or stop by your local PNC Batilc branch offico. Sincerely, National Finaneiai Services Center PNC Bank, N.A. Member FDIC Page 1 of 1 Rev-1510 EX+ (6-98) coMMONweA,l_TH of aENNSVLVANw MHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Luley, Esther R. 21-08-1241 This schedule must be completed and filed 'If the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM utsGRIN iION OF PROPERTY DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. 1 Thrivent Financial For Lutherans - 2,168.78 2,168.78 Annuity/Settlement Agreement No. 09093286. Total death benefit as of date of death $2,168.78. The Decedent's three sons were equally named beneficiaries of this Annuity. TOTAL (Also enter on Line 7, Recapitulation) I 2,168.78 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) ~`"Thrivent financial for Cutherans• 800.THRNENT (800-847-4835) • www thrivent.com Facsimile To Fax number James D Boger '13')_ dl!'~~ From (name and designation) Phone Fax number Jamie French, CFI'd9, FIC 717-502-1100 717-502-1119 Tie Date Financial Concnitant g~09 Address City State ZIP code 101 S. US 13'igL~vay 15, Suite B billsbarg 1PA 17019 Problems with this transmittal, caU Phone Number of pages including cover Kay Stoae, Office Professioaal 717~502.1100 2 RE: tZlcbarQ R Laley insurance and nstriement products, where avadsbk, era dr,~dlral oontracfss (not group rnveraage) and offered by Thnvent Finanaal fir Lutherans, Aprlaton, w! 5417f&0007. NAlC No. 2838-680ta. produc~a issued by Thnvent Fmsma+r Ior tytherane ert availawo to applicants who meet membership. InsurabAHy. U.3. c!t&enshlp and nestdsney requlronwnts. Not aN products descdbed aro avaifeble in ap states. SeauRies are offered through fir/vent Investrnent Management Ina, 626 Fourtl- Ave. 3. Jvfumeapolls MN 554f5~f 665 a wholly owned Subsidiary of Tnrivarrt Fi»anda! for kuMorans. Member F1N1?A, fifember SIPtri ~~prod~ ~ tust se~vioes vfirred fhrvugg~h Thnvent Frnancial BanlG 2000 ~ MrTestone Pr., Appleton, tM 5Ga19~0005 (Mombcr FD1C, p dory, a whopy ewnod arubs/dlary oI7HrHent F/nanclal !or Lutherans. Msuranca, lnv~trnent products, securities, twat, and brvoeanan ntanayo-nent sowkea and accounts aro not dspostts, an not FDIC Insured, aro not Mawad by any tadaral povemment agency, and an not guarantssd by Tbrlherrt l7naneial Beek Virhbfe insurance eonbaeta, Mveateront products, aowrldes, twat' and Nwestmeat manapremeM accounts maygo down 1n value. These faxed docvmenb ere int~ded for the use ofthe addressee and may contain pmrileged or confidential information, if you are not the addressee you may not copy or distribute tlwsa documents, unless aurhor~ed to do so by the addrossee. If you received lhls feu in error. please e:all us tmmediaWly to arrange for fhe wtum of tl~ese faxed documents. 20113 R4-OS TEIItIVENT FINANCIAL FOR LUTH>cRANS EXPLANATION OF DEATH CLAIM PAYMENY Slr17LEIViENT AGREEMENT 09093286 - Notice Uate: December 29, 2008 Paid To: Richard R Luley 5 Emlyn Lane Mechanicsburg PA 17055 The total death benefit for the above settlement agreement owned by Esther R Luley was 52,168.78 nt the tlme of death. The following detailed information explains your payment(s) from the above benefits. i~A7E PAID METHOD OF PAYMENT AMOUNT PAID December 29, 2008 Cash Payment X724.90 If you are requited to report any taxable gain or interest pnyment as a result of this claim transaction, a form 1099R will be sent to you by January 31 of next year. Should you have any questions about this rlnim, please contact your finandal assodate, Jamie C French, nt 717-502.1100. cc: J C French FIC 0165 43402 Richard R Luley 5 Emlyn Lane Mechanicsburg PA 17055 REV•~~s~ oc+t~2-eel COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule 1. ITEM DESCRIPTION NUMBER AMOUNT A. FUNERAL EXPENSES: ESTATE OF FILE NUMBER Luley, Esther R. 21-08-1241 See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address Ciry State Zip Year(s) Commission paid 2. Attorney's Fees Bogar ~ Hipp Law Offices 3. Family Exemption: (If decedent's address is not the same as Gaimant's, attach explanation) Claimant Street Address C~h' State Zip Relationship of Claimant to Decedent 5,175.61 6,252.50 4. Probate Fees 364.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 165.00 7. Other Administrative Costs 5,607.77 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 17,564.88 Copyright (c) 2002 fonn software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Luley, Esther R. 21-08-1241 ITEM NUMBER DESCRIPTION AMOUNT Funeral Exuenses 1 Chef du Jour -Catering for Funeral luncheon 929.76 2 J. Stewart Hardy -Pastoral services for funeral 300.00 3 Malpeai Funeral Home -funeral bill 3.658.57 4 Orris House Inn -Location rental for funeral luncheon 44.80 5 Robert P. Luley -Reimbursement for memorial CD 92.48 6 Tim Koch -Organist for funeral 150.00 H-A Subtotal 5.175.61 Other Administrative Costs 7 Bethany Village 1,183.05 8 Bethany Village 3.95 9 Bethany Village 10.00 10 Bonnie Miller, Tax Collector -local tax 11.00 11 Continuing Care RX -prescription bill 41.30 12 Continuing Care RX -prescriptions 468.59 13 Danesha Brim -Home health care provider (Visiting Angels) 132.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Luley, Esther R. 21-08-1241 ITEM NUMBER DESCRIPTION AMOUNT 14 Holy Spirit Hospital -medical bill 79.92 15 J.R. Norton, DPM -medical bill 40.00 16 Joseph James Jewelers -Appraisal fee 106.00 17 Nancy Luley -Reimbursement for prescriptions 42.45 18 PA Deptartment of Revenue - 2008 Personal Income Tax Quarterly Payment 190.00 19 RESERVES: -Costs to conclude administration of Estate, including filing PA 950.00 Inheritance Tax Return and Inventory and Fiduciary Income Tax Returns 20 Richard F. Luley -Reimbursement for purchase of beverages for funeral 115.54 21 Staples -mailing supplies 19.06 22 U.S. Treasury -.2008 Personal Income Tax Quarterly Payment 278.00 23 United Parcel Service -overnight delivery of correspondence to T. Luley of 25.70 Wachovia Securities 24 United States Postal Service -Postage and mailing supplies- - 16.97 25 United States Postal Service -Postage 21.91 26 UPS Store -postage and mailing supplies 66.37 27 Visiting Angels -home health care 60.50 28 West Shore EMS -medical bill 856.84 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF (FILE NUMBER Luley, Esther R. 21-08-1241 ITEM AMOUNT NUMBER DESCRIPTION 29 West Shore EMS -medical bill 888.62 H-B7 Subtotal 5,607.77 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) REV-1813 EX+ t9-0D) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BEN EFICIARI INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Luley, Esther R. 21-08-1 241 NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECENING PROPERTY Do Not fiat T s {Words) ($$$) I~ TAXABLE DISTRIBUTIONS [include outright spousal and transfers distributions , under Sec. 9116(a)(1.2)] 1 Richard F. Luley Son $50,000.00 and 5 Emiyn Lane two-thirds of Mechanicsburg, PA 17055 rest, residue and remainder 2 Robert P. Luley Son $50,000.00 and 220 Flacon Circle one-third of Keller, TX 76248 rest, residue and remainder Total Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropri ate, on Rev 1500 cove r sheet II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTA L OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 - i Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) LAST WILL AND TESTAMENT OF ESTHER R. LULEY I, ESTHER R. LULEY, of Mechanicsburg, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I devise and bequeath the sum of Fifty Thousand and no/100 ($50,000.00) Dollars to my son, RICHARD F. LULEY, provided, however, that should he predecease me, then to his wife, NANCY S. LULEY. In the further event that both RICHARD F. LULEY and NANCY S. LULEY predecease me, I give and bequeath the sum of Fifty Thousand and no/100 ($50,000.00) Dollars to the children of RICHARD F. LULEY, in equal shares. SECOND: I devise and bequeath the sum of Fifty Thousand and no/100 ($50,000.00) Dollars to my son, ROBERT P. LULEY, provided, however, that should he predecease me, then to his wife, LAURIE S. LULEY. In the further event that both ROBERT P. LULEY and LAURIE S. LULEY predecease me, I give and bequeath the sum of Fifty Thousand and no/100 ($50,000.00) Dollars to the children of ROBERT P. LULEY, in equal shares. THIRD: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, as follows: (A) 0}ze-third (1/3) thereof to my son, ROBERT P. LULEY, provided, however, that should he predecease me, then to _~ his wife, LAURIE S. LULEY. In the further event that both ROBERT P. LULEY and LAURIE S. LULEY predecease me, then to the children of ROBERT P. LULEY, in equal shares. (B) Two thirds (2/3) thereof, to my son, RICHARD F. LULEY, provided, however, that should he predecease me, then to his wife, NANCY S. LULEY. In the further event that both RICHARD F. LULEY and NANCY S. LULEY predecease me, then to the children of RICHARD F. LULEY, in equal shares. FOURTH: I acknowledge that I have a son, PETER J. LULEY. I am making no provision in this, my Last Will and Testament, for PETER J. LULEY. FIFTH: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all proper- ty, exercisable without court approval and effective until actual distribution of all property: (A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivi- Sion, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, including ,~ stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduci- 2 aries, as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) To exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. (G) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. (H) To borrow money from themselves or others in order to pay debts, taxes, or estate or trust administration expenses, to protect or improve any property held under my will, and for investment purposes. (I) To select a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) to the extent the plan or the law permits them to do so, and to exercise any other rights which they may have under the plan, in whatever manner they consider advisable. SIXTH: I direct that all inheritance, estate, trans- y fer, succession and death taxes, of any kind whatsoever, which may be payable by reason of my death, whether or not with respect ~ to property passing under this Will, shall be paid out of the ~ principal of my residuary estate. SEVENTH: I nominate and appoint my son, RICHARD F. LULEY, Executor of this, my Last Will and Testament. In the event of the death, resignation or inability to serve for any reason whatsoever of the said RICHARD F. LULEY, I nominate and appoint my son, ROBERT P. LULEY, Executor of this, my Last Will 3 and Testament. I direct that my Executor and their successors, as the case may be, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this ~~ lay of ~ ~Ly ~ '~ 2 0 0 6 . ~`7 ~ f~ ~~y1SU'~, `~''~, ~~--~.4,~.~s2°,,~' ( SEAL ) ESTHER R. LULEY {~..~ Signed, sealed, published and declared by the above- named Testatrix as and for her Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. Address Address 4